血流矢量在脐带绕颈诊断中的应用

Application of cord blood flow vector in the diagnosis of fetal nuchal circular umbilical cord

目的探讨脐带血流可充分利用的诊断信息,增加超声检测手段。方法利用多普勒超声观察胎儿脐带的血流方向,结合胎方位、胎盘方位及脐动脉的正常流向,判断出脐带缠绕的方向及缠绕角度,并进行分型。结果 214例中,绕1周189例,占88.32%,绕2周15例,占7.01%,绕3周1例,占0.47%,"L"型者9例,占4.20%。按缠绕方向:从左向右者102例,其中臀位20例;从右向左者103例,其中臀位13例;9例"L"型者未统计缠绕方向。按缠绕角度:"C"型者76例,"O"型者39例,"α"型者90例,"L"型者9例。结论利用血流矢量可准确检测脐带绕颈的缠绕方向,按缠绕角度的分型可直观精细地反映脐带缠绕程度,为临床提供详细诊断信息。

Objective To investigate the diagnostic information of umbilical cord blood available and in- crease ultrasonic test facihty. Methods The direction of blood flow may be known according to color Doppler. The fetal umbilical cord, fetal position, placenta position and umbilicus artery afflux were observed in order to get the informations of umbilical cord courser and judge the winding directions, and twining angle. Results In 214 fetuses, one circle of the nuchal umbilical cord were found in 189 fetuses, two circles in 15 fetuses and three circles in one fe- tus. There were two different types according to the winding directions ： type from left to right（ n = 102） and type from right to left（ n = 103 ）, and four different types according to the twining angle ： type＂ C＂ （ n = 76 ）, type＂ O＂ （ n = 39 ）, type＂ ct＂ （ n = 90）, and type＂ L＂ （ n = 9 ）. Conclusion The investigation indicates that the winding directions of nuchal umbilical cord may be judged correctly according to the cord blood flow vector. The typing according to the twining angle can reflect the twining degree of nuchal umbilical cord directly and finely. So, more diagnostic informa- tions will be supplied for clinic.